Barnes Group. HSA Health Plan Options and Health Savings Account Overview. Barnes Group HSA Health Plan Options. Health Savings Account
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1 Barnes Group HSA Health Plan Options and Health Savings Account Overview Barnes Group HSA Health Plan Options Health Savings Account Health Care HSA-Compatible Flexible Spending Account
2 Consider the Barnes Group HSA Health Plan and HSA Account Each of us is unique, with different health care needs and financial goals. It is important to understand how a Barnes Group HSA Health Plan with HSA account can work together, so that you can determine if these options are the best fit for your personal situation in the coming years and during retirement. Advantages of the Barnes Group Health Plan with an HSA Account Preventive care covered at 100% Comprehensive medical plan coverage with out-of-pocket maximum coverage Lower premiums than other Barnes Group medical plan options Ability to save for future health care expenses Barnes Group will make a Company contribution to the HSA of eligible employees
3 The Barnes Group HSA Health Plans ~ Advantage and Value Barnes Group offers two health plans, the Advantage and the Value Plan, that if used with an HSA, provides you with an opportunity to combine medical coverage with a tax-advantaged account that can be used to pay for current and future qualified medical expenses with tax-free dollars. Our Advantage and Value Health Plans are established as a traditional Preferred Provider Organization (PPO) medical plans and use the same network of providers as the POS Choice Medical Plan. Both offer in- and out-of-network benefits with comprehensive coverage including physician visits, hospitalization, and surgery. These plans features higher deductibles in exchange for premiums that are significantly less than the premiums for the POS Choice Health Plan. Routine Preventive Care Services Routine preventive care services are typically covered at 100% when you use in-network physicians. Preventive care services are typically not covered when you use out-of-network physicians. Services are covered as preventive when performed as preventive care by your physician. Any services provided as part of a diagnostic or treatment plan are subject to the deductible and co-insurance. BARNES GROUP HSA HEALTH PLAN COVERAGE OPTIONS Company Contribution to HSA Account HSA ADVANTAGE PLAN (In-Network Benefits) HSA VALUE PLAN (In-Network Benefits) $500 Individual / $1,000 Family $250 Individual / $500 Family Annual Deductible $1,250 Individual / $2,500 Family $2,000 Individual / $4,000 Family Coverage after deductible is satisfied Plan pays 80% of the cost of covered services Plan pays 70% of the cost of covered services Annual Out-of-Pocket Maximum $2,500 Individual / $4,500 Family $3,500 Individual / $7,000 Family Coverage after out-of-pocket maximum is met Plan pays 100% of the cost of covered services Plan pays 100% of the cost of covered services Preventive Care Covered at 100% Covered at 100% Examples of preventive care services: annual physical well-child care routine lab tests ordered conjunction with annual physical Prescription Drugs (Administered by Express Scripts) Retail (up to a 30-day supply): $15 for generic, 35% for preferred brand (min. $50 / max. $100), or 50% for brand drugs (min. $100 / max. $200) Mail Order: (31-90 day supply) immunizations prenatal visits and screenings age-appropriate routine screenings, such as: $30 for generic, $100 for preferred brand, $200 for brand drugs cervical cancer screening prostate antigen screening mammogram colonoscopy For a complete list of preventive care services, visit the Benefits 360 o website at
4 The Barnes Group HSA An HSA is a tax-advantaged account used in conjunction with a high-deductible health plan such as the Advantage of Value Health Plans, which may be used to pay for current and future qualified medical expenses for you, your spouse, and your dependents. You can use your HSA to be reimbursed for qualified medical expenses, including the deductible, coinsurance amounts, and copays. Withdrawals are tax-free1, provided they are used for qualified medical expenses. Unused funds carry over from year to year, and may In addition, you may elect to contribute pretax dollars to your HSA via payroll deduction. You can also make an after-tax contribution to your HSA by writing a check to your account (up to the maximum allowed). If you make an after-tax contribution, you may be able to take a deduction2 for the amount of your contribution when you file your federal income tax return. After-tax contributions can be made up through April 15 of the following year. be used for future qualified medical expenses. HSA eligibility You are eligible to establish an HSA account if you satisfy the following requirements: You are enrolled in either the HSA Advantage or HSA Value Health Plans, sponsored by Barnes Group. You are not covered by any other health plan that is not a high-deductible health plan. For example, you will not be eligible if you participate in a regular health care flexible spending account (FSA), or if you are married and covered as a dependent under your spouse s non-highdeductible health plan BARNES GROUP HSA CONTRIBUTION LIMITS* Barnes Group s Contribution Amount you can contribute ADVANTAGE PLAN Employee Only VALUE PLAN Employee Only ADVANTAGE PLAN Family Coverage VALUE PLAN Family Coverage $500 $250 $1,000 $500 $2,750 $3,000 $5,450 $5,950 Total $3,250 $3,250 $6,450 $6,450 You are not enrolled in Medicare. You cannot be claimed as a dependent on another person s federal tax return. *Provided you are enrolled in one of the qualifying Barnes Group Health Plans for the entire year. If you are hired or rehired mid year, the Company contribution will be prorated based on the number of months during the year you are covered under one of the HSA-compatible Health Plan as of the first day of the month. To help you determine if you are eligible, refer to IRS Publication 969, Health Savings Account and Other Tax-Favored Health Plans, available at Contributions If you enroll in the Advantage or Value Health Plan, Barnes Group will contribute to your account. The Company contribution will be deposited on a pretax, pay period basis, once your HSA has been established but not before your Health Plan coverage becomes effective. Please note: You must be an active employee to be eligible to receive the Company contribution. Individuals on COBRA, unpaid leave of absence and severance are not eligible to receive the Company contribution. However, if the employee returns to work, is enrolled in the Advantage or Value Health Plan and is otherwise eligible to contribute to an HSA, he/she will receive the Company contri- Provided you satisfy the HSA eligibility requirements for the entire year, the maximum annual contribution amount that you can contribute to your account in 2013 from all sources (Company and employee contributions) is $3,250 if you have individual coverage and $6,450 if you have family coverage.3 If you are age 55 or older in 2013, you can make an additional catch-up contribution of $1,000 to your HSA. If you turn age 55 at any time during 2013, you are eligible for the full catch-up contribution amount for the year.
5 The Barnes Group HSA Your responsibility As the owner of this retail account, it is your responsibility to: Ensure you are eligible to establish an HSA account Determine your maximum annual contribution amount from all sources (Employee and employer) Determine whether an expense is a qualified medical expense and therefore eligible for a taxfree withdrawal1 Maintain adequate records and receipts to prove your withdrawals are for qualified medical expenses It is strongly recommended that you become familiar with your responsibilities before you decide to establish a HSA. Refer to IRS Form 8889 for complete details. HSA investment options You can invest your HSA balance and the earnings grow tax free.1 Your funds will automatically be deposited in an FDIC insured deposit account. Your contributions, along with Barnes Group contributions will remain in this simple interest-bearing account unless otherwise directed. HSA Bank provides investment options through TD Ameritrade and Devenir including: Hundreds of mutual funds Individual stocks and bonds Self-directed brokerage account 1State tax treatment may vary. If you contribute to the HSA on an after-tax basis, you can take an above-the-line deduction on your federal income tax filing, which means that your HSA contributions will reduce your gross income used to determine your federal income tax. You are not required to itemize, but you will need to complete form 8889 to report your HSA contributions, and any withdrawals. Using available money in your HSA account You can use the money in your HSA to pay for any current and future qualified medical expenses for you, your spouse, and your dependents on a tax-free basis. Qualified medical expenses must be incurred after your account has been established and include deductibles, coinsurance, COBRA premiums, long-term care premiums (subject to certain limits), and Medicare premiums. For more details on what constitutes a qualified medical expense, please refer to IRS Publications 969 ( and 502 ( or consult with a tax professional. If you need to take a withdrawal from your HSA, you have three ways to access your account: 1. HSA debit card just like a regular debit card, you can use the card for point -of-sale purchases (e.g., prescription drugs for condition-related illnesses). 2. HSA checkbook write checks to providers for any amounts owed after the claim has been processed by Aetna (Fees for checks will apply) 3. Direct reimbursement to you by check request a check be made payable to you for any amounts you paid out of pocket. Just call HSA Bank at or complete and mail a Withdrawal form to HSA Bank for processing. Once you reach your contribution limit, any excess contributions are included in your gross income. In addition, all excess contributions are subject to a 6% excise tax unless the excess contributions and any earnings on those contributions are withdrawn by the tax-filing deadline, including any extensions for the filing of your federal income tax return. For more information, see IRS Publication 969.
6 The Barnes Group HSA You decide how you spend your HSA funds IRS rules govern how you maintain and use your HSA. The IRS does not restrict you from withdrawing funds for any reason, but because an HSA is intended to cover health care expenses, you pay income tax and a possible 20% penalty on funds withdrawn for reasons other than to pay for qualified medical expenses. The penalty does not apply to funds withdrawn after your death, disability, or when you reach age 65. As a reminder, it is your responsibility to maintain records and receipts to prove your distributions are for qualified medical expenses. As required by law, HSA Bank will report distributions from your HSA account to you and to the IRS, on IRS Form 1099-SA. It s your money The funds in your HSA are yours and the account is portable. You can keep your HSA if you change your medical coverage, become unemployed, move to another state, change your marital status, or change jobs. You can choose to keep your account with HSA Bank or roll it over or transfer it to another custodian or institution. Building a balance in your HSA Unlike an FSA, any balance remaining in your HSA carries over from year to year. Over time, you may be able to build a fairly significant balance. It all depends on how much health care you use and whether you choose to withdraw funds from your HSA account to pay for qualified medical expenses. Three tax advantages to consider The HSA offers the following tax advantages*: 1. Contributions are tax free 2. Any investment gains are tax free 3. Withdrawals from the account are tax free when used to pay for qualified medical expenses *State taxes may or may not apply Health coverage in retirement You can use your HSA funds to pay for certain health care coverage in retirement, which can be very costly. For retirees under age 65, you can use your HSA funds to pay for out-of-pocket qualified medical expenses. In addition, for retirees over the age of 65, premiums for Medicare Part A, B, C and D coverage are also qualified medical expenses.
7 Limited Purpose FSA ~ an HSA-Compatible Flexible Spending Account Participation in a health care flexible spending account, such as Barnes Group s standard Health Care FSA, is considered a non-high-deductible health plan, that makes you ineligible to establish and contribute to an HSA. However, participation in the Limited-Purpose FSA, an HSA-compatible Flexible Spending Account does not impact your eligibility to establish an HSA. If you elect to contribute pretax dollars to the Limited-Purpose (HSA-compatible) FSA, you may only be reimbursed for the following types of eligible expenses: n Dental (including orthodontia) n Vision These types of expenses can also be reimbursed from your HSA. However, if you wish to save your HSA funds, you can use the Limited-Purpose FSA to pay for these expenses on a pretax basis. Or, if you expect your eligible dental and vision expenses to exceed the amount you have in your HSA, you may wish to use the Limited-Purpose FSA to save for these expenses on a pretax basis. Please keep in mind that the HSA-Compatible FSA, unlike an HSA, is subject to the use it or lose it rule. Unused money in your Limited-Purpose (HSA-compatible) FSA will be forfeited each year. You should keep this in mind when determining whether to elect and how much to contribute to the Limited-Purpose FSA. In addition, if you intend on using a combination of the Limited-Purpose FSA and your HSA to pay for eligible dental and vision expenses, you may want to consider using the money in your Limited- Purpose FSA first, since this account is subject to the federally required use it or lose it rule, while unused money in your HSA will carry over from year to year.
8 Getting Started Taking Action When you log on to the EnrollOnline system to complete your benefit enrollment, you will have the option to elect coverage under on of the Barnes Group-sponsored HSA Health plans The Advantage or the Value Plan. You will also be provided the opportunity to indicate whether you want to establish an HSA account. How to open your HSA First, you select a Barnes Group HSA Health Plan during the benefit enrollment process. At this time, you will also be presented with the opportunity to elect automatic payroll deductions on a pretax basis to fund your account, up to the annual contributions limit Your enrollment information will be transmitted to HSA Bank where they will verify your identity, required by the Patriot Act and Homeland security, whereby they will open your account, or contact you for additional information, if required. Important! If your account cannot be established for any reason, the Company contribution to your HSA Account will be forfeited. 3. Upon enrollment, HSA Bank will issue each enrolled member with one HSA Debit card, at no cost, which can be used to pay for qualified medical expenses. Additional cards may be requested for a small fee. 4. To request a checkbook for your HSA, you may contact HSA Bank by phone at (800) or by completing and returning a Order Check / Debit Card Form available on the HSA Bank website. A fee of $7.50 will apply for each checkbook issued (Qty. 50). 5. For answers to your questions about topics such as qualified medical expenses, contributions, distributions and investment options, use the following tools: i. IRS Publication 502 (Dental and Medical Expenses) ii. IRS Publication 969 (HSAs and Other Tax-Favored Health Plans) 4 Total contributions include those made by you (via payroll deduction or check), your employer, or third parties. If you would like to make after-tax contributions to your HSA, you may do so by check.
9 Resources for Additional Information For additional tools and resources for the Barnes Group Health Plan options, HSA-Compatible FSA and the HSA, visit For Questions About... General benefits information including eligibility and enrollment Contact... Your designated HR Representative Personalized medical claim status and history under a Barnes Group sponsored Health Plan Aetna HSA account balances, investments, transactions and withdrawal options (debit card, checkbook, EFT) HSA Bank (Mon-Fri 7am-9pm, CT) Personalized claims, transactions, and account balances for the Limited- Purpose (HSA Compatible) FSA Trion Personalized prescription drug claim status and history Express Scripts This Health Plan and Health Savings Account Overview brochure contains general information regarding the terms of the Barnes Group HSA Advantage and HSA Value Health Plans, Health Care HSA Account and Limited-Purpose (HSA-compatible) FSA offered by Barnes Group Inc. ( The Company ). The benefits described in this brochure are available only to benefits-eligible employees. The language used in this brochure is not intended to create, nor is it to be construed to create, a contract between Barnes Group and any one of its employees and former employees. In the event the content of this brochure or any oral or written representations made by any person regarding the HSA Health Plans, HSA Account, the Limited-Purpose (HSA-compatible) FSA or all three of these plans, conflicts or is inconsistent with the provision of the applicable plan document(s), the provisions of the applicable plan(s) are controlling and will govern. Barnes Group Inc. reserves the right to change, suspend, withdraw, amend, modify or terminate the plan(s), in whole or in part, at any time. The information provided in this brochure is general in nature. It is not intended, nor should it be construed as legal or tax advice. Since the administration of an HSA is a taxpayer responsibility, you re strongly encouraged to consult your tax advisor before establishing an HSA. You are encouraged to become familiar with the information available from the U.S. Department of Treasury, which can be found on the Treasury website at You are also encouraged to review information available from the Internal Revenue Service (IRS) for taxpayers, which can be found on the IRS website at You can find IRS Publication 969, Health Savings Accounts and Other Tax-Favored Health Plans, and IRS Publication 502, Medical and Dental Expenses (including the Health Coverage Tax Credit), online, or you can call the IRS to request a copy of each at
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